Healthcare Provider Details

I. General information

NPI: 1033316005
Provider Name (Legal Business Name): KATHERINE NGUYEN WILLIAMS PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2007
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3665 KEARNY VILLA RD SUITE 101
SAN DIEGO CA
92123-1953
US

IV. Provider business mailing address

3020 CHILDRENS WAY MC 5018
SAN DIEGO CA
92123-4223
US

V. Phone/Fax

Practice location:
  • Phone: 858-966-5832
  • Fax: 858-966-6733
Mailing address:
  • Phone: 858-966-5832
  • Fax: 858-966-6733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY22387
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY22387
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: